Padmanabhan Prema, Warade Sonali Kisan, Sejpal Kunjal
Medical and Vision Research Foundation, Chennai, Tamil Nadu, India.
J Cataract Refract Surg. 2010 Jul;36(7):1142-8. doi: 10.1016/j.jcrs.2010.01.022.
To compare the clinical outcomes of a new triple procedure comprising endothelial keratoplasty, phacoemulsification, and intraocular lens (IOL) implantation and a conventional triple procedure comprising penetrating keratoplasty, extracapsular cataract extraction, and IOL implantation.
Cornea Services, Medical Research Foundation, Chennai, Tamil Nadu, India.
In this prospective nonrandomized study, the new triple procedure was performed in eyes with predominant endothelial dysfunction and coexisting cataract and the conventional triple procedure, in eyes with opacities affecting other layers of the cornea. Outcome measures were intraoperative and postoperative complications, 3-month postoperative distance visual acuity, refractive status, mean corneal power, corneal topography, and endothelial cell loss. The outcomes in the 2 groups were compared.
The new procedure group comprised 54 eyes and the conventional procedure group, 26 eyes. All grafts in both groups were clear 3 months postoperatively. The IOL was fixated in the capsular bag in all eyes in the new procedure group and 23% of eyes in the conventional procedure group. Postoperatively, persistent epithelial defects, uveitis, glaucoma, and posterior capsule opacification were significantly more frequent in the conventional procedure group. Visual acuity was significantly better and the postoperative refractive status more predictable in the new procedure group. Endothelial cell loss was greater in the new procedure group than in the conventional group, although the difference was not statistically significant.
The new triple procedure was safer than the conventional triple procedure and resulted in better visual outcomes, a more predictable refractive error, a smoother corneal contour, and a tectonically stronger globe.
No author has a financial or proprietary interest in any material or method mentioned.
比较一种新的三联手术（包括内皮角膜移植术、超声乳化白内障吸除术和人工晶状体植入术）与传统三联手术（包括穿透性角膜移植术、囊外白内障摘除术和人工晶状体植入术）的临床效果。
印度泰米尔纳德邦金奈医学研究基金会角膜服务部。
在这项前瞻性非随机研究中，新的三联手术用于主要存在内皮功能障碍且合并白内障的眼睛，传统三联手术用于角膜其他层出现混浊的眼睛。观察指标包括术中及术后并发症、术后3个月的远视力、屈光状态、平均角膜屈光力、角膜地形图以及内皮细胞丢失情况。比较两组的结果。
新手术组有54只眼，传统手术组有26只眼。两组所有移植片在术后3个月均保持透明。新手术组所有眼睛的人工晶状体均固定于囊袋内，传统手术组有23%的眼睛如此。术后，传统手术组持续性上皮缺损、葡萄膜炎、青光眼和后囊膜混浊的发生率明显更高。新手术组的视力明显更好，术后屈光状态更可预测。新手术组的内皮细胞丢失比传统组更多，尽管差异无统计学意义。
新的三联手术比传统三联手术更安全，视觉效果更好，屈光不正更可预测，角膜轮廓更平滑，眼球结构更坚固。
没有作者对文中提及的任何材料或方法拥有财务或专利权益。
